197,877 research outputs found
Profile of certolizumab and its potential in the treatment of psoriatic arthritis
No full textMaria Sole Chimenti,1 Rosita Saraceno,2 Andrea Chiricozzi,2,3 Alessandro Giunta,2 Sergio Chimenti,2 Roberto Perricone11Unit of Rheumatology, Allergology, and Clinical Immunology, 2Unit of Dermatology, University of Rome Tor Vergata, Rome, Italy; 3Laboratory for Investigative Dermatology, Rockefeller University, New York, NY, USAAbstract: Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy associated with psoriasis (PsO). PsA could be considered an enthesal disease because of the link between mechanical stress (entheses) and immunologically active tissue (synovium). Evidence of efficacy of anti-tumor necrosis factor alpha (TNF-α) is supported by reduction of histological vascularity and immune cell infiltrates in synovial tissue after treatment. Certolizumab pegol (CZP) is a polyethylene glycolylated (PEGylated) Fab′ fragment of a humanized monoclonal antibody that binds and neutralizes human TNF-α. The PEG moiety of the Fab fragment, markedly increases the half-life of CZP and confers to the drug a unique structure that differs from the other anti-TNF-α agents tested for the treatment of Crohn’s disease, rheumatoid arthritis, ankylosing spondylitis, axial spondyloarthritis, nonradiographic spondyloarthritis, PsO, and PsA. In contrast to other anti-TNF-α agents, CZP did not mediate increased levels of apoptosis, suggesting that these mechanisms are not essential for the anti-TNF-α efficacy in Crohn’s disease. As CZP, infliximab, and adalimumab, but not etanercept, almost completely inhibited lipopolysaccharide-induced interleukin-1 beta release from monocytes, this cytokine-production inhibition may be relevant for drug efficacy. Due to these characteristics, it has been demonstrated in clinical studies that CZP effectively improves signs and symptoms of arthritis and physical function and skin manifestations of PsO, with a safety profile similar to rheumatoid arthritis. This drug can be considered as a valid treatment in patients affected by PsA. The efficacy and tolerability profiles suggest CZP as a suitable antipsoriatic drug in the treatment of PsA.Keywords: psoriatic arthritis, certolizumab pegol, biological therapies, anti-TN
Profile of certolizumab and its potential in the treatment of psoriatic arthritis
No full textPsoriatic arthritis (PsA) is a chronic inflammatory arthropathy associated with psoriasis (PsO). PsA could be considered an enthesal disease because of the link between mechanical stress (entheses) and immunologically active tissue (synovium). Evidence of efficacy of anti-tumor necrosis factor alpha (TNF-α) is supported by reduction of histological vascularity and immune cell infiltrates in synovial tissue after treatment. Certolizumab pegol (CZP) is a polyethylene glycolylated (PEGylated) Fab′ fragment of a humanized monoclonal antibody that binds and neutralizes human TNF-α. The PEG moiety of the Fab fragment, markedly increases the half-life of CZP and confers to the drug a unique structure that differs from the other anti-TNF-α agents tested for the treatment of Crohn's disease, rheumatoid arthritis, ankylosing spondylitis, axial spondyloarthritis, nonradiographic spondyloarthritis, PsO, and PsA. In contrast to other anti-TNF-α agents, CZP did not mediate increased levels of apoptosis, suggesting that these mechanisms are not essential for the anti-TNF-α efficacy in Crohn's disease. As CZP, infliximab, and adalimumab, but not etanercept, almost completely inhibited lipopolysaccharide-induced interleukin-1 beta release from monocytes, this cytokine-production inhibition may be relevant for drug efficacy. Due to these characteristics, it has been demonstrated in clinical studies that CZP effectively improves signs and symptoms of arthritis and physical function and skin manifestations of PsO, with a safety profile similar to rheumatoid arthritis. This drug can be considered as a valid treatment in patients affected by PsA. The efficacy and tolerability profiles suggest CZP as a suitable antipsoriatic drug in the treatment of PsA. © 2013 Chimenti et al, publisher and licensee Dove Medical Press Ltd
Spotlight on ixekizumab for the treatment of moderate-to-severe plaque psoriasis: design, development, and use in therapy
No full textAlessandro Giunta,1,* Alessandra Ventura,1,* Maria Sole Chimenti,2 Luca Bianchi,1 Maria Esposito1 1Department of Dermatology, 2Department of Rheumatology, University of Rome Tor Vergata, Rome, Italy *These authors contributed equally to this manuscript Abstract: Psoriasis is a chronic inflammatory disease affecting up to 3% of the general population, associated with discomfort and impaired quality of life. In recent years, the pathogenic cytokine network of psoriasis has been extensively studied leading to the development of new treatments that provide greater efficacy. Interleukin 17A (IL-17A) has been recognized as a crucial cytokine that mediates immunopathogenesis of psoriasis. Ixekizumab – indicated for the treatment of adults with moderate-to-severe plaque psoriasis – is a subcutaneously administered humanized monoclonal antibody that targets IL-17A. A large percentage of patients affected by psoriasis achieved consistent benefits in terms of disease control and rapid onset of action during clinical trials. Overall, ixekizumab brought clinical improvement and a favorable safety profile in phase III trials. Ixekizumab is characterized by consistent efficacy and rapid onset of response; it is not influenced by previous exposure to biologics and has shown good results in areas that are difficult to treat and in severe clinical variants of psoriasis. Ixekizumab has shown significant improvements in the activity of the disease and in those physical functions that inhibit radiographic progression in patients with concomitant involvement of joints. Our data support ixekizumab as a successful therapeutic option for patients affected by moderate-to-severe plaque-type psoriasis. Keywords: biologic therapies, IL-17, ixekizumab, psoriasi
Adalimumab for the treatment of severe psoriasis and psoriatic arthritis
No full textBackground: Psoriasis is a chronic, genetically determined, immunomediated, inflammatory skin disease affecting similar to 2 - 3% of the Caucasian population. Systemic treatment is required in moderate to severe plaque-type psoriasis forms or psoriatic arthritis. However, cumulative organ toxicity, lack of efficacy overtime and other underlying diseases may limit long-term use of conventional treatments. Objectives: TNF-alpha, serves a key role in potentiating inflammatory responses associated with both psoriasis and psoriatic arthritis. Adalimumab is a fully human anti-TNF-alpha monoclonal antibody; approved for the treatment of psoriatic arthritis and, more recently, for plaque-type psoriasis. Methods: This review reports the latest progresses made in the clinical use of 'biologic' drugs for psoriasis focusing on the clinical management of adalimumab in the treatment of plaque psoriasis and psoriatic arthritis. Results: Adalimumab was shown to be effective in treating both psoriasis and psoriatic arthritis with a rapid onset of action and a good safety profile
Un altro modo di apprendere: l'alternanza scuola-lavoro. Una proposta di valutazione della policy
No full textIl fenomeno dell’abbandono scolastico e della disoccupazione giovanile nel Sud d’Europa, in particolare nel sistema educativo italiano, incoraggiano lo studio di politiche di contrasto come l’alternanza scuola-lavoro (dalla fine del 2019 ridefinita come i percorsi per le competenze traversali e per l’orientamento), uno strumento di raccordo tra l’esperienza scolastica e quella del primo contatto con il mondo del lavoro. I processi educativi emergenti dal disegno di policy dell’alternanza scuola-lavoro infatti appaiono essere in rapporto con le strutture sociali nei termini di una reciproca strutturazione tra il sistema scolastico e il sistema lavorativo.
Il lavoro di tesi è volto allo studio delle modalità attraverso le quali le scuole secondarie di II grado italiane hanno introdotto i programmi di alternanza scuola-lavoro nell'ambito delle attività didattiche convenzionali, nell'anno scolastico 2018/2019. Alla base del lavoro vi è l'ipotesi secondo la quale, tenuto conto delle condizioni di contesto (il tipo di percorso formativo della scuola e il contesto territoriale), l'alternanza scuola-lavoro avrebbe potuto configurarsi, da un lato, come un’opportunità di integrazione dell’azione educativa svolta dalla scuola, dall'altro, al contrario, come una mera applicazione da parte degli istituti scolastici delle disposizioni introdotte dalla Legge n. 107/2015.
Lo studio condotto è basato su un'indagine campionaria condotta mediante intervista con questionario (CAWI), rivolta ai referenti scolastici per l’alternanza scuola-lavoro delle scuole italiane. I risultati dell’indagine consentono di attestare sostanzialmente una diversità di condizioni e di risorse (materiali e delle pratiche culturali “locali”) tra le scuole (diverse per tipo di indirizzo formativo) in un territorio eterogeneo come quello italiano, individuando 5 diverse configurazioni dell’alternanza scuola-lavoro emergenti sull’asse semantico opportunità versus adempimento burocratico
Evaluation of Clinical and Ultrasonographic Parameters in Psoriatic Arthritis Patients Treated with Adalimumab: A Retrospective Study
No full textObjectives. The aim of this study was to evaluate clinical and US-PD parameters in PsA during adalimumab treatment. Methods. A retrospective study has been conducted in forty patients affected by moderate-to-severe peripheral PsA. Clinical, laboratory, and US-PD evaluations were performed at baseline, after 4, 12, and 24 weeks of treatment. They included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), visual analogue scale (VAS), Health Assessment Questionnaire (HAQ) modified for Spondyloarthritis, Psoriasis Area Severity Index (PASI) score, the 28-joint Disease Activity Score (DAS 28), and US-PD assessment. US-PD findings were scored according to a semiquantitative scale (ranging 0–3) for synovial proliferation (SP), joint effusion (SE), bone erosions (BE), and PD. Results. Data obtained for clinical, laboratory findings and US-PD evaluation showed statistical significant improvement in all the measures performed except for BE. A significant parallel decrease in SE, SP, and PD values were demonstrated. Conclusion. This study demonstrated that US-PD is a valid technique in monitoring the response to adalimumab in moderate-to-severe PsA
The significance of the development of antinuclear antibodies during infliximab treatment
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